在预测极度早产婴儿死性肠球炎方面,状氧化的临床有用性:一项队列研究
E Palleri1,2, M van der Heide3, J B F Hulscher4
1Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden. elena.palleri@ki.se.
BMC pediatrics
|July 1, 2023
概括
平均血清乳酸水平低于30%可能有助于识别极度早产的婴儿不太可能患有死角性肠球炎 (NEC). 这一发现支持使用这一值来预测新生儿NEC风险.
科学领域:
- 新生儿医学 新生儿医学
- 儿科胃肠病学 儿科胃肠病学
- 临床研究 临床研究
背景情况:
- 肠道微循环受损与死性肠球炎 (NEC) 病原发生有关.
- 之前的研究将血清乳酸和度 (SrSO2) <30%与增加NEC风险联系在一起.
- 这项研究评估了SrSO2<30%对极度早产新生儿NEC预测的临床效用.
研究的目的:
- 评估血清乳酸和度 (SrSO2) 截止值<30%的预测值,用于极度早产婴儿的死性肠球炎 (NEC).
- 为了确定这个值的灵敏度,特异性和预测值.
- 评估低SrSO2和NEC发展之间的关联.
主要方法:
- 一项联合队列观察性研究,包括极度早产婴儿.
- 血清乳酸和度 (SrSO2) 在出生后2-6天之间测量了1-2小时.
- 统计分析包括敏感度,特异性,预测值和为中心调整的赔率比率.
主要成果:
- 在86名婴儿中,17名婴儿出现了NEC. 平均SrSO2<30%在70.5%的NEC病例中被观察到,而对照组的33.3% (p=0.01).
- 对于SrSO2<30%的正和负预测值分别为0.33 (CI 0.24-0.44) 和0.90 (CI 0.83-0.96).
- 婴儿SrSO2<30%的可能性是NEC的4.5倍 (95% CI 1.4-14.3).
结论:
- 在出生后2-6天之间,平均SrSO2切线≥30%可以有效地识别NEC风险较低的极度早产婴儿.
- 这一门可以帮助临床决策制定NEC预防策略.
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